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D ' CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT <br /> P.O. Box 66 (2750 Kelley Parkway) UA S + <br /> Crystal Bay, MN 55323 <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENTS- D k� <br /> General Instructions <br /> 1. You may be required to obtain other permits, i.e. well abandonmment, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24 hour notice is required for all inspections. Call (612) 249-4600. <br /> JOB SITE ADDRESS: 3' �J `fib ' &VE- ` <br /> Occupancy Type: _�r_Residential Commercial <br /> OWNER'S NAME: 't>(Z-t-Lc,E �L L l u OA S I ki 6 C-0, Phone: Lf I Kq D <br /> Mailing Address: l"1 Z D,J© K 4V $0 City: Z 13al <br /> CONTRACTOR'S NAME: 44L SG h k" (os t S01JBus.No.: 3't() 7q5 2000 <br /> Mailing Address:(0 0 ''rm 60.6 2 q S City: CI 1 <br /> Demolition if planned by means of: manual disassembly <br /> x heavy equipment <br /> Permits Issued: <br /> 4 Well Abandonment <br /> In return for issuance of said Demolition Permit,the undersigned owner hereby agrees as follows: <br /> 1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is <br /> complete. <br /> 2. Demolition debris will be kept off adjoining property and/or the public rights-of-way unless <br /> specific prior approval is obtained in writing for temporary use thereof. <br /> 3. Foundations shall be completely removed from the ground. <br /> 4. All demolition debris shall be completely disposed of off site in accordance with all <br /> applicable PCA requirements. <br /> 5. Water wells must be abandoned in accordance with State Health Department regulations. <br /> 6. Inspection required when all debris has been removed, before backfilling. <br />